New LGBTI clinic faces fierce government criticism

Gay rights activists have opened Uganda's first clinic for lesbian, gay, bisexual, transgender and intersex (LGBTI) people in the capital, Kampala, where it will provide testing, counselling and treatment for HIV and other sexually transmitted infections.

"We need our own clinic because we have had health service providers, and in some cases other clients at the health centre, attack us either because they suspect us to be gay or know that we are gay," said Pepe Julian Onziema, programme director and acting advocacy officer at Sexual Minorities Uganda (SMUG), a local rights group. "The main idea of the clinic is to provide voluntary counselling and testing, HIV/AIDS treatment and care, and promote general wellness."

"We don't feel safe. Some practitioners gossip about you when you are right there, increasing stigma. When I was about 16, I went to test for HIV and I was asked to bring my partner so we could be tested and counselled together. I brought someone of my sex and we were sent out and not catered for," Onziema said. "At this clinic, we want to protect our community from such humiliation, and stress and promote health and wellness."

A recent AIDS Indicator Survey puts Uganda's HIV prevalence at 7.3 percent, but according to the Crane Survey, a 2008/09 study of high-risk groups in Uganda, HIV prevalence among men who have sex with men (MSM) was 13.7 percent.

Despite the high level of HIV among MSM, the government has not included the group in its national strategy to fight HIV because homosexual activity is illegal in Uganda. A bill before parliament seeks even more stringent punishments for people engaging in homosexual acts and those perceived to be "promoting" homosexuality.

The clinic was opened on 19 May 2012 by Bishop Christopher Senyonjo - one of the country's few religious leaders willing to speak for gay rights - and is managed by a local gay rights lobby group, Ice Breakers Uganda (IBU).

"The clinic is being run by professional health workers. It will offer better avenues in health seeking behaviours among the LGBTI community," said Denis Wamala, an IBU official. "The clinic will offer free care, support and treatment services to LGBTI in Uganda... here they can easily open up because they are free."

Government criticism

Richard Nduhura, Uganda's Minister for Health (General Duties), told IRIN/PlusNews the clinic was unnecessary because despite the government's anti-gay stance, "We don't discriminate and marginalize when it comes to offering health services. When people come for treatment at our health facilities, we can't ask for their sexual orientation."

The Director General of the Uganda AIDS Commission (UAC), Dr David Apuuli Kihumuro, agreed. "It's nonsense for them [LGBTI] to say that they are always discriminated against in the provision of health services. I have been a doctor for over 40 years... I have never heard where a patient has been asked about his or her sexual orientation," he said.

A surgeon at Mulago National Referral Hospital in Kampala, Dr Robert Mawanda, told IRIN/PlusNews: "We swear an oath. It instructs us to treat [patients] without harm and injustice, so we can't discriminate against anybody, based on sexual orientation. We treat all people without asking their orientation."

Despite Uganda's commitment to improved HIV prevention, few programmes reached most at-risk populations such as MSM and sex workers, and condoms were not sufficiently targeted to these groups, a Modes of Transmission analysis found in 2009.

The Minister for Ethics and Integrity, Samuel Lokodo, has said he intends investigating the clinic for promoting homosexuality. "If we find out that it's [the clinic] related to promoting the culture which doesn't conform to our morals as a country, we shall instantly ban and close it," he told IRIN/PlusNews.

We have had health workers, and in some cases other clients at the health centre, attack us because they suspect us to be gay or know that we are gay

"These people [LGBTI] are doing their operations under cover - it's not easy to track them. However, we shall not allow any social gathering, association, infrastructure or any activities that exist to promote homosexuality," he said.

"If the clinic was for offering social services to the people, that would be good. However, this clinic is meant for giving assurances those who are involved in it [homosexuality]. It's supposed to treat the ruptured backs [anus]. We can't allow this."

The fear of attacks by the government and members of the public means the location of the clinic has not been made public, but LGBTI networks are being used to alert the community to its existence. "Our community members know about the clinic and they access it. The media have written about it too... Of course we are afraid. We live in fear daily about the public because it acts ignorantly," said SMUG's Onziema.

"The Ugandan Constitution guarantees the right to health, and the right to life, among others. Although the government, through the UAC acknowledged that there is a need to address HIV/AIDS among MSM, it has ignored our plight in addressing the issue, and left us no choice but to fend for ourselves."